The relationship of Alzheimer-type pathology to dementia in Parkinson's disease.

Lewy body degeneration of the subcortical nuclei other than the substantia nigra is common in PD and may represent the substrate for a higher vulnerability to dementia in patients with PD. Cortical pathologies of Alzheimer and Lewy body type seem to be the major determinants of dementia. The prevalence of Alzheimer's disease is not increased in PD, but "early" cortical Alzheimer lesions (usually sub-clinical in normal controls) are frequently associated with dementia in PD. Furthermore, dementia in PD is heterogeneous and should always prompt the clinician to search for treatable causes.